甲状腺功能在正常范围内,亚临床甲状腺功能低下和心房的风险
Christine Baumgartner1, Bruno R da Costa2,3, Tinh-Hai Collet4
1Department of General Internal Medicine, Inselspital, Bern University Hospital, (C.B., M.F., C.F., D.A., N.R.).
Circulation
|October 25, 2017
概括
在正常范围内较高的自由甲状腺素 (fT4) 水平与心房动 (AF) 的风险增加有关. 在这项研究中,甲状腺刺激激素 (TSH) 水平与AF风险没有显著关联.
科学领域:
- 心脏病学
- 内分泌学
- 流行病学
背景情况:
- 心房动 (AF) 是一种常见的心脏病,与严重的健康后果如心力衰竭和中风有关.
- 对于制定预防策略至关重要的是了解可修改的肌痛风险因素.
- 以前的研究表明亚临床甲状腺功能高和AF之间存在联系,但甲状腺功能在正常范围内和亚临床甲状腺功能低的作用仍然不清楚.
研究的目的:
- 研究甲状腺功能在甲状腺和亚临床甲状腺功能范围内的关联以及发生心房动 (AF) 的风险.
- 确定甲状腺刺激激素 (TSH) 和自由甲状腺素 (fT4) 水平是否是AF发生率的独立预测因素.
主要方法:
- 对前性队列研究进行了系统审查和个人参与者数据的元分析.
- 分析了来自11个群体的数据,其中包括超过3万名参与者.
- 考克斯的比例危险模型用于评估基线TSH和ft4水平与事件AF之间的关系,根据TSH范围定义甲状腺和亚临床甲状腺功能下降状态.
主要成果:
- 在非甲状腺患者中,较高的自由甲状腺素 (fT4) 水平与发生性甲状腺炎的风险显著增加有关.
- 在甲状腺刺激激素 (TSH) 水平和发生的甲状腺功能障碍患者之间没有发现显著的关联.
- 在调整心血管疾病后,高fT4和AF风险之间的关联仍然显著.
结论:
- 在甲状腺功能范围内的更高的循环自由甲状腺素 (fT4) 水平与发展心房的风险增加有关.
- 甲状腺刺激激素 (TSH) 水平,无论是在甲状腺和亚临床甲状腺功能低下的范围内,都没有发现与发生甲状腺炎的风险增加有关.
- 这些发现表明fT4水平,而不是TSH,可能是对非甲状腺风险评估的相关因素.
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